This essay is going to discuss my learning about Interprofessional working (IPW) and Interprofessional education (IPE). Pollard et al., (2010) defined Interprofessional working as “the process where members of different professions and or agencies work together to provide integrated health and or social care for the benefit of service users”. The two day IP conference (2011), was a great opportunity to meet different professionals and agencies from different areas of health and social care profession and share their views and understanding on IP working and IP learning. The Centre for Advancement of Interprofessional Education (CAIPE) has defined IPE as “Interprofessional Education occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care" (CAIPE, 2002). CAIPE uses the term "Interprofessional education" (IPE) to include all such learning in academic and work based settings before and after qualification, adopting an inclusive view of "professional".
Based on the key themes, we discussed how Interprofessional collaboration can provide best possible care to the service users and analyse where the services are lacking. Through group discussions, key note addresses and seminars, I was able to learn about the communication issues between the health and social care professionals, contrasting professional perspectives and values, ethics within teams and stereotyping, power imbalances and team processes ( Fletcher, 2008).
Improving the quality of communication is now a key priority for health and social care (DoH, 2008). Staffs at all levels are expected to work in partnership with multi-professionals and agencies. Service users expect, and demand, greater equality in service provision. The effective communication of patient information underpins collaboration between health and social care practitioners as well as the efficient and safe delivery of care to the patients (DoH, 2008). During discussions, everyone in our group agreed that current mechanisms for information transfer are inadequate, and have largely depended on informal means of communication between professionals. Where ‘formal’ mechanisms exist, communication is improved but difficulties remain across professional and organisational boundaries. We agreed on the statement that “communication is subjective for each profession but ultimately need to achieve the highest level of patient care”.
Fletcher (2011), suggests there are interprofessional ethical issues and challenges when practitioners from different professions work closely together in the fields of health and social care. The NMC Code (2008) states “You must work co-operatively within teams and respect the skills expertise and contributions of your colleagues.” Seminars from the conference on this theme emphases how to learn and work effectively within a multi-professional team. Tomorrow’s Doctors (GMC, 2009), explains how to understand and respect the roles and expertise of health and social care professionals in the context of working and learning as a multi-professional team and understands the contribution that effective interdisciplinary team-working makes to the delivery of safe and high-quality care. We should work with colleagues in ways that best serve the interests of patients. We also discussed issues of confidentiality and information sharing in practice and research with vulnerable people. There are challenges for teaching and learning about ethics in interprofessional settings, the potential of virtue ethics and an ethic of care for understanding and handling ethical issues in interprofessional practice and the extent to which interprofessional working may be about surveillance and control.
According to Beauchamp and Childress (2001) the ethical framework has four ethical principles; respect for autonomy, beneficence, non-maleficence and justice. The need to understand and handle ethical issues in interprofessional working is contributing to the revitalisation of professional ethics as a dynamic field of study and we agreed on the statement that “It is evident that there is contrast in professional values i.e. Spiritual, financial and moral etc. but perspectives can result in the downfall of Interprofessional working. Recognition of these differences will help to place the patient at the centre of care.”
Hean et al., (2006, p162-181) suggested that students bring with them stereotypical views of different professional groups. Health and social care (HSC) students hold stereotypical views of other HSC professional groups is of great potential importance to team working in health care. During the course of discussion, all professionals expressed their views on stereotyping. Midwives, social workers and nurses were rated most highly on interpersonal skills and on being a team player whilst doctors were rated most highly on academic ability. Doctors, midwives and social workers were perceived as having the strongest leadership role, whilst doctors were also most highly rated on decision making. All professions were rated highly on confidence and professional competence and, with the exception of social workers, on practical skills. Pharmacists and doctors were perceived as having very similar characteristics as were social workers, midwives and nurses. However, the profiles of nurses and doctors were perceived to be very different. The implications of these similarities and differences are discussed in terms of their potential impact on interprofessional interactions, role boundaries and team working. It has been argued that stereotypes may interfere with interprofessional team working (Barnes et al., 2000); (Miller et al., 2001); (Carpenter et al., 2003). By concluding the discussion we agreed on the statement that “Stereotyping in health and social care professionals do exists and certain aspects may be negative, but positive allow for a high level of care”.
Power and politics is no easy task as it requires and understanding and acceptance within the interprofessional settings. Fletcher (2008) states “Traditional power boundaries are still present in many areas of health and social care that limit the effectiveness of IPE.” Power is shared and fluctuates in accordance with whose knowledge and expertise best meets the need of the client / service user. Some may struggle with this as power has traditionally been sanctioned through and within the health and social care, has been located within the medical profession. Sharing power can be perceived as a threat to professional autonomy and joint working can engender professional rivalry and envy if those involved feel that sharing their status and unique position within health and social care practice. Our statement on this subject is, “As health and social care professionals, we have power through our knowledge and procedures, this can be used for the protection and safety of the patients, but can be abused to the neglect of vulnerable persons”.
Meads et al (2005) suggest values in Interprofessional education focuses on the needs of individuals, families and communities to improve their quality of care, health outcomes and wellbeing, applies equal opportunities within and between the professions and all with whom they learn and work. This relies on acknowledging, but setting aside differences in power and status between professions, respecting individuality, difference and diversity within and between the professions and all with whom they learn and work, utilising distinctive contributions to learning and practice. Maintain the identity and expertise of each profession, presenting each profession positively and distinctively. This was very evident in our conference and group discussions. We respect other professionals individuality and following on our ground rules.
The IP conference helped me to improve my understanding of IPW and IPL. With regard to my experience in adult nursing it was a great opportunity for me to interact and discuss my view with other professionals and learned a lot from their perspectives. I believe effective team working can change all issues that we are presently facing in health and social care. In my future career I hope this learning experience will help me to provide best possible care to the service users.